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Exercise Is Good for Breast Cancer Survivors

Short bursts of exercise can help improve breast cancer survivors’ health and help them feel better, according to new study findings.

The results, from M. D. Anderson’s six-month “Active for Life after Breast Cancer Study,” were published in the July 14 issue of the journal Patient Education and Counseling.

“The wonderful take-away message from this study is that simple exercises, such as walking during coffee breaks or parking farther away from work, can have beneficial effects on physical health and functioning,” says the study’s principal investigator Karen Basen-Engquist, Ph.D., associate professor in M. D. Anderson’s Department of Behavioral Science. “Exercise doesn’t need to be a daunting activity or even an organized outing to reap significant rewards for breast cancer survivors.”

Study description: Who exercised and how much?

In the study, 60 breast cancer survivors were placed randomly into either a lifestyle intervention group or a standard care control group.

Lifestyle intervention group – Researchers taught participants to incorporate short periods of moderate exercise into their daily routines, which included 30 minutes of physical exercise at least five days per week. Participants met weekly for four months and then semi-weekly for two months to learn cognitive and behavioral skills to support effective behavioral change.

Standard care control group – Members of this group did not meet or receive guidance on incorporating exercise into their lives.

Basen-Engquist notes that study leaders invited participation from a pool of breast cancer survivors who had recently completed both radiation and chemotherapy. Women who maintained primarily sedentary lifestyles were chosen as ideal candidates “because we wanted to see if through the study they would integrate exercise into their daily lives,” she says.

Primary results: Exercise group fared well

Study results show that lifestyle intervention group members:

Walked an average of 100 feet farther than the control group
Showed significant physical improvement over the control group
Made significant progress incorporating exercise throughout the day
“We found that exercise improved participants’ ability to perform certain physical tasks, increased self-reports of feeling healthy and decreased pain and the degree to which their activities were limited by physical health problems,” Basen-Engquist says.

The study also examined exercise barriers including:

Time restraints
Other commitments
Fatigue
Pain or muscle problems
Incontinence
Hot flashes
Goal of study: Improve quality of life for survivors

In recruiting study participants, M. D. Anderson partnered with the Kelsey Research Foundation, a non-profit organization dedicated to improving the quality of patient care and health outcomes through research and education; Kelsey-Seybold, a large, multi-specialty health care clinic; the Sisters’ Network Inc. - Houston Chapter, a support and advocacy group for African-American breast cancer survivors; and The Rose, a Houston non-profit agency that sponsors support groups for breast cancer survivors

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“We help women with hair loss look and feel confident…with style, fit, and comfort.”

Hair Loss

The normal scalp contains approximately 100,000 hairs. They are constantly growing, with old hairs falling out and being replaced by new ones. Some cancer treatments will cause people to lose some or all of their hair, usually in clumps during shampooing or brushing. Sometimes clumps of hair are found on the pillow in the morning.
It is normal for men and women to feel distressed about hair loss. It helps to understand why it happens, to know that hair will grow back, and to take some steps to minimize the problem.

Hair loss happens when chemotherapy drugs travel throughout the body to kill cancer cells. Some of these drugs damage hair follicles, causing the hair to fall out. Hair loss is very variable. Some patients have it, and others do not, even with the same drugs. Not all drugs cause hair loss. Some drugs can cause hair loss on the scalp and elsewhere on the body. Some drugs can cause only the loss of head hair. Like chemotherapy, radiation therapy to the head often causes scalp hair loss, and sometimes, depending on the dose of radiation to the head, the hair does not regrow naturally.

If hair loss does occur, it usually begins within two weeks of the start of therapy and gets worse one to two months after the start of therapy. Your scalp may feel very sensitive to washing, combing or brushing during the short time when your hair is actually falling out. Hair regrowth often begins even before therapy is completed.

What the Patient Can Do

If you think you might want a wig, buy it before treatment begins or at the very start of treatment. If you do this before hair loss begins, the wig shop can match your hair color and texture.
Be sure to get a prescription from your doctor for the wig because it is often covered by insurance.
Obtain a list of wig shops in your area from your doctor or nurse, other patients, or from the phone book.
Women with long hair often go to a good salon for a stylish short cut and have a beautiful wig made from their own hair.
If you buy a wig, try on different ones until you find one that you really like. Consider buying two wigs, one for everyday and one for special occasions.
Before you need the wig, be gentle when brushing and shampooing your hair, and wear a hat or scarf outdoors in cold weather to prevent loss of body heat.
Hair loss can be reduced somewhat by avoiding too much brushing or pulling of hair, and by avoiding heat (e.g., electric rollers, hair dryer, curling iron).
Wear a hair net at night, or sleep on a satin pillowcase to keep hair from coming out in clumps.
Avoid braids or ponytails, and use a wide-toothed comb.
Be gentle with eyelashes and eyebrows, which are sometimes affected as well.
If you are bothered by hair falling out, you may choose to shave your head.
Use a sunscreen, sunblock, or hat to protect your scalp from the sun.
Turbans or scarves can be alternatives to wigs. Cotton items tend to stay on your smooth scalp better than nylon or polyester.
When new hair grows out, it may break easily at first. Avoid perms for the first few months. Keep hair short and easy to style.

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“We help women with hair loss look and feel confident…with style, fit, and comfort.”

Low-fat Diet May Reduce Breast Cancer Risk
Medical Journal Cites Significance of the Findings

By Renee Twombly

New clinical trial results linking a low-fat diet to a reduced risk of breast cancer are quite substantial and should be taken seriously by women wanting to help prevent the disease, according to the author of an editorial in the Journal of the American Medical Association.

The commentary, made by Aman Buzdar, M.D., a professor in M. D. Anderson’s Department of Breast Medical Oncology, appears in the publication’s Feb. 8 issue, along with the study itself. The 15-year clinical trial, sponsored by the Women’s Health Initiative (WHI), involved 49,000 women from across the United States.

Some researchers argue that the results are not “statistically significant” because a statistical goal set by study investigators was not met. “The conventional way to look at any data is that findings are considered real (statistically significant) if there is 95% probability that results are not by chance. The finding of this study didn’t meet those rigorous criteria. Instead there is a 91% probability that these findings are real. It failed the magic 95% probability rule, Buzdar says. “And that’s about as close as they got. What this tells me is that, for the first time, women have something they can do that may help them modify their cancer risk.”

Women decrease fat, increase vegetables and grains

In the WIH study, 40 clinical centers throughout the United States enrolled women, ages 50-79, who had not been diagnosed with breast cancer. Neither group was asked to reduce their calorie intake.

The women were asked to do one of the following:

Change their diet – 40% (19,541 women) agreed to:

Reduce fat to 20% of calorie intake
Eat five daily servings of vegetables
Eat six daily servings of grain
Not change their diet – 60% (29,294 women) agreed not to make any dietary changes.

Past studies do not determine dietary influence

The new study is the most rigorous so far, Buzdar says. A number of studies have found that, as a group, women who eat a diet low in fat develop fewer cases of invasive breast cancer than women who eat more fat. Other studies have further concluded that a low-fat diet protects against cancer recurrence after a woman has been treated.

But the problem with most of the earlier studies, Buzdar says, is that they all have been “retrospective” − meaning that researchers looked at women who did, or did not, develop cancer, and then they tried to understand, through questionnaires, what lifestyle choices might have contributed to whether a woman developed cancer.

What is needed, he says, is a clinical trial that is prospective, randomized and controlled. That is, a study like the WIH trial that follows women for a number of years to see if they develop breast cancer and that arbitrarily places participants in one of two groups. One group would eat a low-fat diet. The other, a “control” group, would have no dietary restrictions. At the end of the study, outcomes between the groups would be compared.

Buzdar concludes that women should take a “glass half full” approach to the latest findings, recognizing that it may be within their power to ward off breast cancer.

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